The results were calculated using a measure called “effect size”, which is a way of quantifying the size of the difference between the two groups. For the difference in quality of life scores between groups, the effect size was calculated to be 0.24. This can be interpreted as a “small” effect. In other words, treatment including CBT gave a small improvement in quality of life compared with usual care.

Tinnitus also could be the result of neural circuits thrown out of balance when damage in the inner ear changes signaling activity in the auditory cortex, the part of the brain that processes sound. Or it could be the result of abnormal interactions between neural circuits. The neural circuits involved in hearing aren’t solely dedicated to processing sound. They also communicate with other parts of the brain, such as the limbic region, which regulates mood and emotion.
Tinnitus is commonly described as a ringing in the ears, but it also can sound like roaring, clicking, hissing, or buzzing. It may be soft or loud, high pitched or low pitched. You might hear it in either one or both ears. Roughly 10 percent of the adult population of the United States has experienced tinnitus lasting at least five minutes in the past year. This amounts to nearly 25 million Americans.

Standard masking devices help to mask the sound of tinnitus while you are using them, but they have no long-lasting effects. Modern medical-grade devices use customized sounds tailored specifically to your tinnitus. Unlike regular sound machines, these devices are only worn intermittently. You may experience benefits long after the device is turned off, and over time, you may experience long-term improvement in the perceived loudness of your tinnitus.
Steven Doerr, MD, is a U.S. board-certified Emergency Medicine Physician. Dr. Doerr received his undergraduate degree in Spanish from the University of Colorado at Boulder. He graduated with his Medical Degree from the University Of Colorado Health Sciences Center in Denver, Colorado in 1998 and completed his residency training in Emergency Medicine from Denver Health Medical Center in Denver, Colorado in 2002, where he also served as Chief Resident.
Superior semicircular canal dehiscence syndrome is another not uncommon cause of pulsatile tinnitus. The superior semicircular canal is one of three canals found in the vestibular apparatus of the inner ear. The vestibular apparatus helps to maintain equilibrium and balance. In this syndrome, a part of the temporal bone that overlies the superior semicircular canal is abnormally thin or absent. Superior semicircular canal dehiscence syndrome can affect both hearing and balance to different degrees.
While there is currently no cure for tinnitus, treatment options like Tinnitus Control at least provide patients with the ability to successfully manage the ringing they hear by suppressing the cause of it. This is achieved through their proprietary blend of the following active ingredients: arnica, chininum sulphuricum, ferrum metallicum, kali phosphoricum, natrum sulphuricum, pulsatilla, silicea, thiosinaminum, garlic and gingko biloba.
Muscle spasms: Tinnitus that is described as clicking may be due to abnormalities that cause the muscle in the roof of the mouth (palate) to go into spasm. This causes the Eustachian tube, which helps equalize pressure in the ears, to repeatedly open and close. Multiple sclerosis and other neurologic diseases that are associated with muscle spasms may also be a cause of tinnitus, as they may lead to spasms of certain muscles in the middle ear that can cause the repetitive clicking.
Vitamin Supplements. Vitamin supplements, like Lipo-Flavonoid Plus, contain the vitamins that some studies have shown to be beneficial to inner ear health. These include Vitamin C, B-1, B-2, B-6, B-12, zinc, niacin and calcium. And while I am a proponent of vitamins, I advise my patients to take a regular OTC multivitamin that costs $15, versus Lipo-Flavonoid Plus, which has the same ingredients, but costs up to $90 for the same number of pills, just because it’s packaged and marketed to people that suffer from tinnitus.
Limit use of earplugs. Earplugs are important to use to protect your hearing when you’re likely to be exposed to loud noises. (Remember, exposure to loud sounds, and noise-induced hearing loss, are common causes of tinnitus, and may make tinnitus worse if you already have the condition.) But otherwise, people with tinnitus are advised not to wear earplugs, including for sleep. Earplugs reduce your ability to hear external noise and can make tinnitus more noticeable.
Most people with tinnitus also have hearing loss. Hence, hearing aids can be an effective part of any sound therapy.  Hearing aids alone can provide partial or total relief from tinnitus. If you’re experiencing challenges with your hearing as well as tinnitus, a combination of a hearing solution with built-in sound generators can often be prescribed. You can expect improved levels of hearing which also helps to minimise the effects of the condition in the same way that sound therapy might.
Notch Therapy can reduce the perception of tinnitus after wearing your hearing aids for weeks or months without hearing an audible signal like static noise or ocean waves.  The goal of Notch Therapy is for your brain to learn to ignore the tinnitus sound.  This type of treatment is most effective for people who have tonal tinnitus – the most common type of tinnitus.  Notch control is set up in the Miracle-Ear programming software by the hearing care specialist and the settings are fine tuned with you to match the pitch of the tinnitus. This feature is available in our GENIUS™ 2.0 solutions.

Patulous Eustachian tubes can be associated with tinnitus. The Eustachian tube is a small canal that connects the middle ear to the back of the nose and upper throat. The Eustachian tube normally remains closed. In individuals with a patulous Eustachian tube, the tube is abnormally open. Consequently, talking, chewing, swallowing and other similar actions can cause vibrations directly onto the ear drum. For example, affected individuals may hear blowing sounds that are synchronized with breathing.
Antibiotics, including erythromycin, neomycin, polymysxin B and vancomycin, as well as cancer medications, including mechlorethamine and vincristine, and water pills, including bumetanide, furosemide or ethacrynic acid all have the ability to cause or worsen tinnitus. Some patients will experience tinnitus after using antidepressants or quinine medications.
Can an iPhone app truly relieve tinnitus? Believe it or not, the answer is yes. The ReSound LiNX2 app utilizes a combination of sound therapy and relaxation exercises to reduce the severity of tinnitus. The convenient app can be used in combination with hearing instruments, which are small but strong. This groundbreaking program transforms your iPhone into a remote control for your hearing aid.
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According to the American Tinnitus Association, this complex audiological and neurological condition is experienced by nearly 50 million Americans. (2) Older adults, men, people who smoke or use drugs, and those with a history of ear infections or cardiovascular disease have the highest risk for developing tinnitus. Most experts believe that it’s not a disorder itself, but rather one symptom of another underlying disorder that affects auditory sensations and nerves near the ears. However, there are tinnitus treatment options out there to treat those symptoms.

Other potential sources of the sounds normally associated with tinnitus should be ruled out. For instance, two recognized sources of high-pitched sounds might be electromagnetic fields common in modern wiring and various sound signal transmissions. A common and often misdiagnosed condition that mimics tinnitus is radio frequency (RF) hearing, in which subjects have been tested and found to hear high-pitched transmission frequencies that sound similar to tinnitus.[71][72]
Currently there is no cure for most cases of tinnitus. Depending on the type of tinnitus, symptoms will tend to come and go over time. Stress level, diet, and exposure to noise can worsen tinnitus. Many people find their tinnitus annoying but can learn to adapt without difficulty. It is likely that if you have had tinnitus, you will have it again in the future.

You don’t need to enroll in an eight-week program to get started with mindfulness training. Participants in the MBTSR program all received a copy of the groundbreaking book “Full Catastrophe Living” by Jon Kabat-Zinn. Kabat-Zinn’s book is the premier manual for practicing mindfulness in daily life. You will learn about, and be encouraged to practice, meditation and breathing techniques that can help draw your focus away from tinnitus.


A diagnosis of tinnitus is based upon identification of characteristic symptoms, a detailed patient history, a thorough clinical evaluation and complete audiologic testing. These steps will help to differentiate rhythmic tinnitus from non-rhythmic tinnitus. It cannot be overemphasized that tinnitus is a symptom of another underlying condition and not a diagnosis in and of itself. Because of the high number of underlying causes of tinnitus, a variety of specialized tests to detect the specific cause may be necessary. Attempting to identify the underlying cause of tinnitus is the first step in evaluating a person with tinnitus.
This well-designed study found that using CBT alongside elements of standard therapy can help patients with tinnitus of varying severity. However, the differences in outcomes between the two groups were quite small, and this technique can only help manage tinnitus rather than curing it, as some papers implied. Also, the patients in the study were followed for only 12 months, so it is unclear whether this approach can help in the longer term.
Since most persons with tinnitus also have hearing loss, a pure tone hearing test resulting in an audiogram may help diagnose a cause, though some persons with tinnitus do not have hearing loss. An audiogram may also facilitate fitting of a hearing aid in those cases where hearing loss is significant. The pitch of tinnitus is often in the range of the hearing loss.
Hyperacusis is a different, but related condition to tinnitus. People with hyperacusis have a high sensitivity to common, everyday environmental noise. In particular, sharp and high-pitched sounds are very difficult for people with hyperacusis to tolerate—sounds like the screeching of brakes, a baby crying or a dog barking, a sink full of dishes and silverware clanging.  Many people with tinnitus also experience hyperacusis—but the two conditions don’t always go together.
TRT depends upon the natural ability of the brain to "habituate" a signal, to filter it out on a subconscious level so that it does not reach conscious perception. Habituation requires no conscious effort. People frequently habituate many auditory sounds -- air conditioners, computer fans, refrigerators, and gentle rain, among them. What they have in common is that they have no importance, so they are not perceived as ''loud.'' Thus, the brain can screen them out.
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